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Help, please? Renal cyst DX

  1. #1
    Stuart, Florida
    Question Help, please? Renal cyst DX
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    Ok, I'm doing a bit of overthinking again.

    If the doctor writes, "renal cyst" as the diagnosis but does NOT specify as aquired or congenital, do we code from the 753 code range or from the 593 code range?
    If you look in the index, under "cyst", at kidney cyst it refers you to 753.10. I'm unsure as to whether or not that is the correct code selection since it is in the Congenital section. Does the doctor have to specify as congenital for this code? Or is it the other way around, and the doctor only needs to specify if it is NOT congenital?

    Subjective states: Patient is here to follow-up on renal U/S - discussed with pt. results. Patient feels well - denies complaint.

    Objective: blah blah blah (no need to type it all out)

    Assessment: renal cyst

    Plan: Repeat U/S in 1 year
    Vanessa Mier, CPC

  2. #2
    Green Bay, WI
    In my opinion, since the doctor isn't specifically stating that this is a "congenital" cyst of the kidney, I would code 593.2.

  3. Default
    I would post 593.2 as well.

  4. #4
    Default congenital cyst
    congenital means you were born with it. If it is a NEW finding you know it's not congenital

  5. Default
    Use 593.2(Acquried cyst of kidney).

    Nalini CPC

  6. #6
    Stuart, Florida
    Thank you all for your answers. As I'm sure you all know, there are often times where a diagnosis will fall under a certain code because of NEC/NOS. This is where my confusion lies. Like I said before, if you look up renal cyst, the index directs you to 753.10. In my book, there is no further explanation, under codes 753.10 or 593.2, to elaborate to whether or not to use for renal cyst NOS.

    Prutzman, I was aware of the meaning of congenital. However, how am I to know whether the cyst is congenital or not? This could be the first time a congenital cyst was discovered, making it a "new finding" that's not necessarily NEW. The note makes no mention of WHY the U/S was done, if this was the first or hundredth U/S done, or any additional information to draw a conclusion from. It does state that the patient has no complaints though. When I asked the doctor, "How do you know when renal cyst is congenital or acquired, upon receiving U/S results?", he told me that there is no such thing. I tried to explain that, yes, there is such a thing as a congenital renal cyst, meaning it's been there from birth, and acquired, meaning that it was acquired later on in life. He continued to argue that there is no such thing. I went to show him a medical dictionary and he argued some more and walked away. He's the physician and I am only a coder and, no matter how much I KNOW I'm right, it means nothing to him. So, unfortunately, I was unable to get any clarification from him.
    Vanessa Mier, CPC

  7. Default
    I know this is waaaaaay late but:

    Renal cysts. Although the official ICD-9-CM coding guidelines require assigning 753.11 (congenital single renal cyst) for “renal cysts,” many coders prefer to assign 593.2 (cyst of kidney, acquired) because in most cases, kidney cysts are acquired and not congenital. Regardless of “common sense,” however, a coder must follow the guidelines promulgated by the ICD-9-CM book and the Coding Clinic. CodeRyte subject matter experts report often seeing clients' coders incorrectly changing 753.11 to 593.2.

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